Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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Poor sleep quality is a consistently reported by patients in the ICU. In such a potentially hostile environment, sleep is extremely fragmented and sleep architecture is unconventional, with a predominance of superficial sleep stages and a limited amount of time spent in the restorative stages. Among the causes of sleep disruption in the ICU are factors intrinsic to the patients and the acute nature of their condition, as well as factors related to the ICU environment and the treatments administered, such as mechanical ventilation and drug therapy. ⋯ There is evidence that multifaceted interventions focused on minimizing nocturnal sleep disruptions improve sleep quality in ICU patients. In this article, we review the literature regarding normal sleep and sleep in the ICU. We also analyze sleep assessment methods; the causes of poor sleep quality and its potential implications for the recovery process of critically ill patients; and strategies for sleep promotion.
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Observational Study
The rapid shallow breathing index as a predictor of successful mechanical ventilation weaning: clinical utility when calculated from ventilator data.
The use of the rapid shallow breathing index (RSBI) is recommended in ICUs, where it is used as a predictor of mechanical ventilation (MV) weaning success. The aim of this study was to compare the performance of the RSBI calculated by the traditional method (described in 1991) with that of the RSBI calculated directly from MV parameters. ⋯ The satisfactory performance of the RSBI as a predictor of weaning success, regardless of the method employed, demonstrates the utility of the method using the mechanical ventilator.